Seen Locum at surgery due to low heart rate

[Octopus52]

Saw locus today. Advised not to take bisoprolol if HR dips under 50. Have to go back for med review as my notes say I take bisoprolol 2.5mg once a day and flecanide 50mg twice a day. My consultant put me on bisoprolol and told me to take flecanaide up to 200mg as pilin pocket. I have never in 7 years taken flecanaide daily!

[cuore]

Am I missing something here? Your GP increased Bisoprolol from 22.5mg to 5mg with your heart rate dropping to 43-48, and he wanted to double to 10mg. I fail to see the logic. Was the Nebivolol instead of or added to the Bisoprolol as your heart rate was below 60? I believe you are saying instead of.

[shirlygirly]

I had the same problem with bisoprolol started off at 2.5mg but

passed out after being on it for a month or so. Went to GP next day

and my heartrate down in the 30's. My GP said I will get in touch

with your cardiologist carry on as you are! When we got home my

husband rang him and was told to stop the Bisop and see him.

I was put on 1.25mg and took that for about 7 years but it was never

successful at controlling my af. After 3 ablations I have just had Pace

and Ablate. Hope you are more successful with other medications than

me, I just couldnt tolerate any. It does often take time to find the right

medicate for you.

Good luck.

[jedimasterlincoln]

I've always sat at 60-70 on 10mg bisoprolol, when unmedicated but regular a few years ago resting HR was in the 90s....

Some days it does drop below 50 for a time but nothing major

[Nugger]

Was on 10 mg Bishop, then after cardioversion they told me to still take it but just 5mg, this was while I was waiting to go home after the op, now my heart rate was in the low 40s & I questioned them , are you sure & they said yep.

So next day after taking 0nly 2.5 mg my heart rate was 35-40, so I stopped taking it, I did tell them about the low heart rate & they had me wear a monitor for 24 hrs, never heard a thing back from them.

I’m suppose to be still taking 200mg amioderone/5mg Bishop & eliquis but haven’t taken any since my cardioversion on 12 July & never felt better

[KMRobbo]

I was only on bisoprolol 1. 25mg and only for a week.my hr was mid low-mid 40s. My GP said it was too low as when asleep I would be 8 ish below that and that in the 30s was seen as too low.

I was not happy on bisop anyway as I fell asleep 40 minutes after talking each tablet and felt awful when I woke 4 or 5 hours later and had no exercise tolerance at all.

[cuore]

That story is mind-boggling. Thank God you got out of his clutches. I trusted my GP, who also knew little, for a full year, enough to go into persistent AF. The price of that error is that i am having to have extensive ablation beyond the pulmonary veins (had two ablations - going for a third). I still go to the same GP, as it is difficult to switch where I live, but not for AF.

There should be a mandatory course on arrhythmia for all GPs who graduated without learning about it. Alternatively or better, it should be mandatory for all GPs to refer immediately patients with arrhythmia to EPs rather than arrogantly try to handle it themselves, which they have no business doing. I was not even asked if I wanted to return to sinus rhythm but merely put on rate control to keep me in arrhythmia. Unfortunately, I knew little at that point in time. When persistent, and more knowledgeable, I asked what about anti-arrhythmic drugs? The answer was that he wasn't licensed for them.

My conclusion is that GPs have no business handling arrhythmia.